MEDICARE: NAVAI & O'MELIA, DDS, PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1770613556
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NAVAI & O'MELIA, DDS, PA

Provider Business Mailing Address
First Line	:	9141 BALTIMORE NATIONAL PIKE
Second Line	:
City	:	ELLICOTT CITY
State	:	MD
Zip	:	21042-3935
Country	:	US
Telephone Number	:	410-465-1868
Fax Number	:	410-461-4357

Provider Business Practice Location Address
First Line	:	9141 BALTIMORE NATIONAL PIKE
Second Line	:
City	:	ELLICOTT CITY
State	:	MD
Zip	:	21042-3935
Country	:	US
Telephone Number	:	410-465-1868
Fax Number	:	410-461-4357

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. MANOUCHEHR NAVAI
Credential	:	DDS
Telephone Number	:	410-465-1868

Provider Enumeration Date	:	03/07/2007
Last Update Date	:	08/22/2020

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